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Clinical Observation
April 11, 2011

Left Main Trunk Coronary Artery Dissection as a Consequence of Inaccurate Coronary Computed Tomographic Angiography

Author Affiliations

Author Affiliations: Department of Cardiovascular Medicine, The Cleveland Clinic Foundation, Cleveland, Ohio. Drs Galla and Becker are now with the Departments of Cardiovascular Medicine, Providence Hospital, Mobile, Alabama, and Saint Vincent Heart and Vascular Institute, Erie, Pennsylvania, respectively.

Arch Intern Med. 2011;171(7):698-701. doi:10.1001/archinternmed.2010.464

A 52-year-old white female nurse with a medical history that was notable for hypertension and mild obesity presented to her local primary care physician with the recent onset of chest pain. Further investigation revealed that in an effort to lose weight and assist in the control of her hypertension, she had adopted a new diet and exercise program several weeks earlier. At her initial presentation, she described 48 hours of nonexertional, sharp chest pain that was aggravated by elevation of her right arm and deep inspiration. She denied associated symptoms of shortness of breath, nausea, vomiting, or diaphoresis, and her office electrocardiogram showed no abnormalities.

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